ThinkBirmingham
job application form
Birmingham City Council is committed to equal opportunities in employment and we positively welcome your application irrespective of your gender, race, disability, colour, ethnic or national origin, nationality, sexuality, gender identity, marital status, responsibility for dependants, religion, trade union activity and age.
Please complete all sections on the form. If any section does not apply to you, enter not applicable (n/a). It is important that you refer to the Guidance Notes before completing this form. Electronic versions of this form are available at
This form is also available in large print, Braille or on audio tape on request.
FOR OFFICE USE
Job ref: / IT
Date sent out:
Date returned:
Application no:
Closing Date:
1. Vacancy DetailsThis section must be completed
Job title: / Public Health Apprentice / Directorate: / People / Service Area: / Public Health
2. Personal Details
First name(s): / Last name: / Title:e.g.(Mr,Mrs,Ms):
Former name(s): / Date of Birth:
Address:
Postcode:
Daytime tel no: / Evening tel no:
Mobile tel no: / Email:
Please indicate if you are happy to receive correspondence via your email address e.g. invite to interview letter: / Yes No
National Insurance Number, if you have one
Do you have the Right to Work in the UK? Yes No
Please note: original identification documents verifying your right to work in the UK will be requested, checked and a photocopy will be taken. If your application is successful and you commence employment the copy of your identification documents will be retained on file under the regulations governed by the Immigration, Asylum and Nationality Act.
Current driving licence (if this is a requirement of this job): / Yes No
If YES, type of licence
3. General Information / 4. Arrangements for interview
a)Are you related to a Councillor or employee of
Birmingham City Council? Yes No / If you have a disability, are there any arrangements which we can make for you if you are called for an interview and/or work based exercise? Yes No
If yes, please provide details:
Name: / If yes, please specify, (e.g. ground floor venue, sign language interpreter, audio tapes etc).
Position:
Relationship:
Directorate:
b) Do you wish to job share the job you are applying for? Yes No
5. Education/Qualifications(including overseas) Please start with secondary education.
From / To / Secondary School/ / Examinations taken / Results / Date
mth / yr / mth / yr / College/University etc / or to be taken / & grades / gained
6. TrainingPlease list any course(s) which you have undertaken which are relevant to the job and/or specified on the person specification.
Year / Organising body / Course title / Length
Please continue on a separate sheet if necessary.
7. Membership Please indicate membership of any organisation(s) relevant to this job.
Name of organisation / Type of membership / Date of membership
8. Past Employment & Experience (if any) include voluntary or other relevant experience.
From / To / Employer / Job Title / Reason for change
mth / yr / mth / yr
Please continue on a separate sheet if necessary.
9. Present or Most Recent Employment (if any)
Job title: / Employer:
Salary:
Date Started: / Date left (if applicable):
Address:
Postcode:
Reason(s) for leaving (if applicable):
10. Ill Health Retirement/Dismissal
Have you ever taken ill health retirement from Birmingham City Council or been dismissed for some other reason?
Yes No
If yes, please give the date and department/directorate:
11. References Please give details of two referees one of which must be your current or most recent line manager/supervisor, or other person designated within the organisation to provide references.
Please put a cross in the appropriate box(es) below if you do not wish us to take up a reference without
your consent.
Name:
Address:
Postcode:
Tel no: / Email:
Job title: / Relationship to you:
If this referee knows you by another name please give that name:
Name:
Address:
Postcode:
Tel no: / Email:
Job title: / Relationship to you:
If this referee knows you by another name please give that name:
Please note some jobs may require a Criminal Records Bureau check, further information regarding this will be contained in the application pack, if applicable.
12. Other information in Support of your Application
In order for us to decide whether to call you for interview, it is essential that you provide us with sufficient details of any experience and skills which demonstrate how you meet the requirements of this apprenticeship, as set out in the person specification and most importantly the 5 questions highlighted below. You may also continue on a separate sheet(s) if you wish. You should ensure that any additional sheets are attached securely and include your name and job reference number / job title.
YOU MUST FULLY ANSWER THESE 5 QUESTIONS
What is your understanding of Public Health and why have you applied for this apprenticeship?
What is your understanding of the term ‘Health inequalities’?
Can you give an example of where you have worked in a team?
How do you feel when under pressure and dealing with conflicting priorities?
How would you organise yourself to balance your studies and job?
information in Support of your ApplicationContinued….
13. Data Protection Act 1998 - Consent and Certification of Details
The information detailed in this application form may be used by Birmingham City Council in the monitoring and progression of its employment policies and practices, and in particular its Equal Opportunities in Employment Policy. This monitoring is for statistical purposes only and you will not be identifiable from this process. However, your personal details contained in the application form may be used in the prevention and detection of fraud. Where this occurs you will be identifiable. The information may be disclosed to the following third parties:
- Survey and research organisations (for monitoring purposes only).
- Local Government Authorities
- Central Government Authorities
- Organisations that handle or investigate the proper use of public funds
- Law Enforcement Authorities
I, (print name):
Consent to Birmingham City Council recording and processing the information detailed in this application form. I understand that this information may be used by the City Council in pursuance of its business purposes and my consent is conditional upon the City Council complying with their obligations under the Data Protection Act 1998.
I also confirm that the information contained in this application form is correct.
Signature: Date:
If you are making your application in Braille or on audio tape you must declare that you have read and understood this section and that the information you have given is true and correct at the time of completion. You may also be required to sign a declaration to this effect at a later date.
Application forms not fully completed may be refused. Applications Forms must be returned before the closing date - xxxxx. Forms returned after this date will be refused.
Return Address: